Name of the Procedure:

Common Name(s): Hospice Services

Technical or Medical Term(s): Hospice Care (HCPCS Code G9694)

Summary

Hospice services are specialized care provided to patients who are facing a terminal illness where curative treatment is no longer an option. The focus is on improving the quality of life, managing pain and other symptoms, and providing emotional and spiritual support to both the patient and their family.

Purpose

Medical Conditions Addressed:

• Advanced terminal illnesses where treatment is aimed at comfort rather than a cure (e.g., advanced cancer, end-stage heart or lung disease).

Goals/Expected Outcomes:

• To alleviate pain and manage symptoms.
• To offer emotional, spiritual, and psychological support.
• To improve the quality of remaining life.
• To facilitate a dignified end-of-life experience.

Indications

Specific Symptoms or Conditions:

• Severe, progressive diseases with a prognosis of six months or less to live, if the disease follows its usual course.
• Patient or family has chosen to focus on comfort care rather than curative treatments.

Patient Criteria:

• Certification by two physicians of a terminal illness.
• Desire for the patient and family to receive hospice care.

Preparation

Patient Instructions:

• No special preparatory steps needed as it is initiated based on patient needs and physician directives.

Diagnostic Tests/Assessments:

• Clinical evaluation confirming a terminal diagnosis and prognosis.
• Discussions regarding the patient's wishes and advanced care planning.

Procedure Description

Step-by-Step Explanation:

1. Eligibility Assessment: Confirm patient meets criteria for hospice services.
2. Plan Development: Develop a personalized care plan with input from the patient, family, and healthcare team.
3. Care Implementation: Begin delivering services, including medical care, pain management, and emotional support.
4. Ongoing Monitoring: Regularly adjust care plans according to the patient's evolving needs.

Tools/Equipment/Technology:

• Various medical supplies for pain and symptom management.
• Resources for psychological, emotional, and spiritual support.

Anesthesia/Sedation Details:

• Use of medications to manage pain and other distressing symptoms as needed.

Duration

• Hospice care continues for as long as the patient meets criteria and opts to receive it. Duration can range from days to several months.

Setting

• Hospice care can be provided in different settings: patient’s home, hospice centers, hospitals, or long-term care facilities.

Personnel

• Multidisciplinary team including physicians, nurses, social workers, chaplains, counselors, and trained volunteers.

Risks and Complications

Common Risks:

• Medication side effects, like drowsiness or nausea.

  Rare Risks:

• Medication reactions or untreated symptoms if care coordination is inadequate.

Possible Complications:

• Managing complex symptoms may be challenging requiring frequent adjustments.

Benefits

Expected Benefits:

• Symptom relief and improved quality of life.
• Emotional and spiritual support for patient and family.

• Greater comfort during end-of-life care.

  Realization Time:

• Benefits can be immediate and continue throughout the duration of hospice care.

Recovery

• There is no recovery in the traditional sense, as hospice care is intended for those approaching the end of life.
• Focus is on comfort and quality of life until the end.

Alternatives

• Palliative Care: Similar in focus but can be provided alongside curative treatments.

• Intensive Medical Care: Continued aggressive treatment of the disease, suitable for those not yet in a terminal stage.

  Pros and Cons:

• Hospice provides extensive support and symptom management, but not curative treatment.
• Intensive medical care may extend life but can reduce quality of life.

Patient Experience

During Procedure:

• Patients can expect compassionate care tailored to their comfort and symptom management needs.

After Procedure:

• Continuous support from the healthcare team.

  Pain Management and Comfort Measures:

• Comprehensive pain management and comfort measures are central to hospice care.
• Emotional and psychological support to ease distress is provided.